Dual Task Practice in Parkinson's Disease (Duality-PD)
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Purpose
The ability to perform two or more tasks together is impaired in Parkinson's Disease (PD). Based on pilot work we hypothesize that dual tasking is amenable to training in PD and will not compromise safety. In the proposed study we will therefore collect high level evidence on whether 6 weeks of integrated dual task gait training is more effective than consecutive task practice. The investigators will use a randomized, single blind study design and conduct the same protocols in two academic centers (Katholieke Universiteit Leuven and Radboud Universiteit Nijmegen). The investigators intend to test an experimental condition which consists of focused dual task training in the home using a novel program of personalized cognitive tasks. The aim of dual task training is to teach motor-cognitive task integration and achieve optimal levels of automaticity and functionality. The control arm will receive gait practice and separate cognitive training of the same intensity, but offered consecutively. We will test the hypothesis that dual task training (integration) will have more pronounced effects on complex gait than consecutive task training.
Sub-analysis will be conducted on patients with and without freezing of gait. The investigators expect that integrated dual task training may be less effective in patients with freezing, due to the increased fall risk and impaired cognitive profiles.
Overall, this project will provide evidence to support future directions for motor learning and innovative rehabilitation targets.
| Condition | Intervention | Phase |
|---|---|---|
|
Parkinson's Disease |
Behavioral: physical therapy |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) |
| Official Title: | Motor Learning in Parkinson's Disease: a Randomized Comparison of Integrated Versus Consecutive Dual Task Training |
- Gait speed during dual task conditions (untrained Auditory Stroop task, trained Digit Span) [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]Change scores will be calculated, comparing the change over the two baseline timepoints with the change after 6 week intervention. The change between the first baseline timepoint and the last timepoint (24 weeks) will also be compared.
- Functional Dual task, single task gait measures, cognitive outcomes, Freezing of Gait Questionnaire, Quality of life scores (PDQ39) [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]Change scores will be calculated, comparing the change over the two baseline timepoints with the change after 6 week intervention. The change between the first baseline timepoint and the last timepoint (24 weeks) will also be compared.
- Fall rate as determined by weekly phonecall [ Time Frame: 24 weeks ] [ Designated as safety issue: Yes ]Change scores will be calculated, comparing the change over the two baseline timepoints with the change after 6 week intervention. The change between the first baseline timepoint and the last timepoint (24 weeks) will also be compared.
| Estimated Enrollment: | 120 |
| Study Start Date: | June 2011 |
| Estimated Study Completion Date: | September 2014 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Integrated dual task training
Integrated dual task training delivered by a physiotherapist. In this training mode walking practice will be combined with simultaneously carrying out cognitive discrimination, verbal fluency and memory tasks.
|
Behavioral: physical therapy
Physical therapy consisting of gait training 3 times a week for 6 weeks
Other Name: Exercise
|
|
Active Comparator: Consecutive task training
Consecutive task gait training delivered by a physical therapist. In this training mode, walking practice will be conducted separately, focusing on the motor task only. Training of cognitive discrimination, verbal fluency and memory tasks will be done consecutively while the subjects are sitting.
|
Behavioral: physical therapy
Physical therapy consisting of gait training 3 times a week for 6 weeks
Other Name: Exercise
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 40 Years to 80 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Hoehn & Yahr stage II-III in the on-phase
- Able to walk for 10 minutes continuously
- Dual task interference of at least 5% using a cognitive secondary task
- Without cognitive impairment (MMSE > 24)
- On stable medication
- Diagnosis of Parkinson's disease made by a movement disorders specialist
Exclusion Criteria:
- Deep Brain stimulation
- Living alone
- Severe medical conditions affecting gait
- Hearing problems
- Likely to change medication regimen.
Contacts and Locations| Contact: Alice M Nieuwboer, PhD | 0032 16 329119 ext 29119 | alice.nieuwboer@faber.kuleuven.be |
| Contact: Marten Munneke, PhD | 0031243614701 ext 4701 | M.Munneke@neuro.umcn.nl |
| Belgium | |
| Department of Rehabilitation Sciences, Katholieke Universiteit Leuven | Recruiting |
| Leuven, Vlaams Brabant, Belgium, B-3001 | |
| Contact: Alice Nieuwboer, PhD 003216329119 alice.nieuwboer@faber.kuleuven.be | |
| Contact: Hilde Feys, PhD 003216329079 Hilde.feys@faber.kuleuven.be | |
| Principal Investigator: | Alice M Nieuwboer, PhD | Katholieke Universiteit Leuven |
More Information
No publications provided
| Responsible Party: | Alice Nieuwboer, Professor, Katholieke Universiteit Leuven |
| ClinicalTrials.gov Identifier: | NCT01375413 History of Changes |
| Other Study ID Numbers: | Gossweiler Foundation, Duality-Gossweiler |
| Study First Received: | June 15, 2011 |
| Last Updated: | November 13, 2012 |
| Health Authority: | Belgium: Directorate general for the protection of Public health: Medicines |
Keywords provided by Katholieke Universiteit Leuven:
|
Parkinson's disease Gait Rehabilitation Cognition Freezing of gait |
Additional relevant MeSH terms:
|
Parkinson Disease Parkinsonian Disorders Basal Ganglia Diseases Brain Diseases |
Central Nervous System Diseases Nervous System Diseases Movement Disorders Neurodegenerative Diseases |
ClinicalTrials.gov processed this record on May 16, 2013